Thyroid meds with coffee

DebE13 · Post by **DebE13** » Wed Dec 10, 2014 6:05 am

I was reading that drinking coffee with thyroid meds can interfere with absorption. I am an offender with topic but will continue to attempt to justify my reasoning.

Waiting an hour for my cup of coffee in the morning is not something I care to do. But as I complain that I feel like crap I question how smart I really am.

I don't believe this is the answer to my undertreatment woes but if there is something I can control, then I should be doing it.

Now for my warped justification..... I am a very rigid, routine orientated person. It is innate. I don't forget my meds, I take them at the same time daily, I have my labs drawn at the same time every time I have them done, I have the proper time lapse when I have labs done so there aren't false readings because the meds are newly in my system, etc. I take my levothyroxine at 9pm and don't eat past 7 pm. I take my liothyronine when I wake or around 5am each morning (lately I've been getting up 3:30-4 am, sigh). I have one cup of coffee with chocolate almond milk within a half hour of waking. I eat breakfast at 7am before I leave for work. My theory was if I never stray from that routine my labs would show how much is being absorbed and if it wasn't enough then I would be increased. Therefore, by keeping the same routine any coffee interference would be balanced by an adjustment in my meds. Am I being stupid?

I have my second cup of coffe for the day around 9am and thats it. I need to mention that coffee is one of my last loves left after MC. I did eliminate it for a little over a month previously to see if my guts showed improvement. Sadly, I was happy it didn't. I used to drink four cups a day but it didn't sit right with me so I settle for two.

Another gripe is the lack of instruction by doctors about optimal pill taking. Maybe they assume everyone does their own research or they've said it so many times they forget every patient may be new to this. I was given the pills with a "here you go" and that was it.

I'm wondering since I only get a measely 5mcg of liothyrinine a day, maybe taking it at 5am is not the best time to take it. There are so many different numbers out there as far as how long to wait before eating and how long to wait after. Even the water consumption has me wondering. I can't drink an ample amount of water with my meds before I go to bed. I take it with enough to get it down or I will be up at night peeing. I have enough sleep issues that I can't add midnight potty runs to the mix.

JFR · Post by **JFR** » Wed Dec 10, 2014 6:26 am

Your justification makes sense to me, Deb. Of course I too count on 2 cups of coffee in the morning so I am an unlikely person to tell you to do differently. It is impossible to do things perfectly. In fact there probably isn't any perfect out there, just people constructing rules trying to approximate it. I would stick with your regimen which sounds pretty good to me. Worrying about it may be doing your more harm than any changes you might make. Of course I could be wrong.

Jean

Skyward · Post by **Skyward** » Wed Dec 10, 2014 6:37 am

I like your reasoning and I also think that your idea of always having lab work done at the same time is brilliant. I don't know if it would ever be possible for me to pull that off- but I might at least be aware of the time differences if I was trying to make heads or tails of something.

Post by **tex** » Wed Dec 10, 2014 9:45 am

Deb,

with Jean and Sarah that your logic is sound.

One question though — why do you take the levothyroxine at 9 pm? Isn't that the main portion of your treatment? Like most people, I take my (Armour) supplement first thing in the morning, before breakfast.

Tex

Post by **tex** » Wed Dec 10, 2014 9:50 am

Deb,

One other question — have you ever had your vitamin B-12 level checked in recent years?

Tex

Pat · Post by **Pat** » Wed Dec 10, 2014 1:51 pm

Deb,

I was wondering the same question about the time of day that you take your levo. My bottle says to take 1/2 hour to 1 hour before breakfast and not within 4 hours of vitamins or minerals. I take my vitamins at lunch. Thyroid med is a stimulant so that may be why you have sleep issues. Talk to your pharmacist. They are the ones that know everything about medication.

Pat

Post by **tex** » Wed Dec 10, 2014 2:06 pm

Pat wrote:Thyroid med is a stimulant so that may be why you have sleep issues. Talk to your pharmacist. They are the ones that know everything about medication.

Excellent points.

Tex

DebE13 · Post by **DebE13** » Wed Dec 10, 2014 7:18 pm

http://thyroid.about.com/od/thyroiddrug ... edtime.htm

This article caught my attention and night time fit into my schedule very well. I've read so many varying times to wait before and after eating that is was too confusing to figure out which was the correct time to be most effective. It's easy for me to be consistent because I am always ready for bed at 9 pm no matter what and it's not difficult to have nothing to eat after 7am. The mornings are more hectic and eating varies.

I never have issues falling asleep but the quality is poor. I have a lot all over body aches and pains at night that wake me. My three cats definitely don't help.

My sleep has never been the same since I had issues with prednisone side effects years ago. Although, the quality issues have become more problematic since my thyroidectomomy. So maybe the night time plan itsn't the best for me?

Sadly, I have no use for my pharmacist. I fight them each time I get my scripts filled. They continue to insist changing manufacturers is not a problem and often attempt to give me a bottle with split manufacturers. I have found Mylan for the levothyroxine and Paddock for the liothyronine seems to have the safest MC ingredients. I am a pain in their rear ends because they screw it up literally almost everytime I renew it. It's too much hassle for them to special order it. But I insist on doing it my way. I have no confidence in their opinions because they are there to push pills and make money. I was told I should do my business with them on their off hours because they don't have time to spend with me and my special requests during their busy times of day. The only reason I don't change is Walgreens is everywhere and I go "up north" often to our cabin and I like tbe idea of having access to my records/pharmacy if need be when I'm away from home.

Can both be taken at the same time in the morning or would it be best bump the liothyronine to the afternnon after lunch?

I had my DVB-12 lab done in November of 2013. It was 1878 pg/mL (normal range 160-1000). I'm not sure what the "DV" part means but that was part of the lab test name on my chart.

I have an appointment Friday with my PCP, should I be asking for more than a cortisol test?

Post by **tex** » Wed Dec 10, 2014 9:56 pm

Deb,

I can see how taking thyroid supplements at bedtime could boost their effectiveness (or at least boost the markers of effectiveness, namely TSH, T3, and T4. But the problem is that the physical effects (on the body) of thyroid supplementation peak as the supplement is absorbed, and then the physical and neurological benefits slowly decline.

True, absorption is usually better, and consequently your labs look better when the treatment is taken at night (and therefore your doctor is a happy camper). But you're not a happy camper, because you miss a lot of the benefits of the treatment, due to the fact that you are asleep while the treatment is having it's strongest effects. Right? And to add insult to injury, the relative increase in energy, alertness, etc., that the treatment promotes can adversely affect your sleep pattern.

Personally, unlike most doctors, I'm not as impressed by lab results as I am by actual physical benefits.

I see no reason why you cannot take both supplements at the same time.

Tex

P. S. Your B-12 level was almost surely elevated last year because of your thyroid cancer. Cancer is known to promote elevated B-12 levels.

Pat · Post by **Pat** » Wed Dec 10, 2014 10:26 pm

Interesting article, Deb. Never heard that before.

Pat

TXBrenda · Post by **TXBrenda** » Wed Dec 10, 2014 10:52 pm

For what it is worth, my thyroid medication is a compound that contains T3 and T4 in a single capsule. I take my prescription meds in the morning at least 30 minutes before I eat breakfast. Most of the time, I take them shortly after I get up and then take my shower. Then I eat breakfast. When I have a doctor appointment that involves lab work, I don't take the meds until after the blood samples have been drawn.

Of course, my situation is different because I still have my thyroid but it doesn't function very well.

DebE13 · Post by **DebE13** » Thu Dec 11, 2014 7:08 am

Thank you Tex for your thoughts. Makes sense. I am switching to the AM today and see if that helps some of my sleep issues. I look like the walking dead. Kind of sad I was helping my endo be happy with my numbers.

I would imagine my numbers will continue to be spectacular, hopefully the dragging butt will improve too.

Thanks for your experience Brenda. Some articles/people's comments I've read said to wait up to two hours before eating. That just isn't doable for me. I generally eat an hour to and hour and a half after getting up so knowing 30 minutes works for you gives me some peace of mind. I'm always a bit leary when trying to determine which sources are reliable. Thank God for this site. Even though we are all different and some strategies may or may not work, it's comforting to get advice from my internet family.

I think I will ask my PCP to order labs for Bs and D since my last check was over a year ago and I was dealing with a major change. Interesting about the cancer/ B12 correlation. Is that for all cancers?

Post by **tex** » Thu Dec 11, 2014 10:45 am

Deb wrote:Interesting about the cancer/ B12 correlation. Is that for all cancers?

There's a lot of speculation, but rather limited data to work with. The original study can be found at the link below. Current opinions indicate an association with liver, lung, colon, hematological, and smoking and alcohol-related cancer. But obviously the less common cancer forms (such as thyroid cancer) are not likely to be well-represented by a study such as this (IOW, the researchers probably wouldn't have enough data to reach any conclusions about such less-common cancers, based on the study results).

Elevated Plasma Vitamin B12 Levels as a Marker for Cancer: A Population-Based Cohort Study

In the reports on this research, the term "Cbl" refers to cobalamin (B-12). Note that high B-12 levels do not appear to cause cancer, they're just associated with it. My B-12 level has been high for many years (probably since I've been taking Metanx)

As always, you're most welcome,
Tex

BearcatRx · Post by **BearcatRx** » Thu Dec 11, 2014 6:48 pm

Did someone call the pharmacist???

LindyLou · Post by **LindyLou** » Thu Dec 11, 2014 10:21 pm

Actually, it appears Levothyroxine is better absorbed if taken at nighttime.
http://www.ncbi.nlm.nih.gov/pubmed/17201800